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Same Donor Post-Stem Cell Transplant Boosts Outcomes

Lower immunosuppression, better survival rate when same living donor used for lung transplant

THURSDAY, June 30 (HealthDay News) -- Patients who undergo living-donor lobar lung transplantation (LDLLT) after hematopoietic stem cell transplantation (HSCT) have a higher success rate when the same living donor is used, according to a study published online June 14 in the American Journal of Transplantation.

Fengshi Chen, M.D., Ph.D., from Kyoto University in Japan, and colleagues evaluated outcomes for 19 patients who underwent LDLLT after HSCT. Eight patients underwent LDLLT where one of the donors was the same living donor as for the HSCT (SD group), and 11 patients received LDLLT from relatives who were not the HSCT donors (non-SD group). Three patients underwent single LDLLT in the SD group.

The investigators found that the five-year survival rate was 100 percent for the SD group and 58 percent for the non-SD group. Postoperative immunosuppression was significantly lower in the SD group compared to the non-SD group. In the non-SD group, two patients died of infection and one died of post-transplant lymphoproliferative disease (PTLD). Only a single patient in the SD group died of PTLD seven years after LDLLT. Two patients in the non-SD group had a relapse of hematologic malignancy. Immunosuppression was carefully tapered in the three single LDLLTs in the SD group.

"In our study, LDLLT involving the same donor as for HSCT appeared to have advantages related to lower immunosuppression compared to LDLLT from relatives who were not the HSCT donors," the authors write.

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